August 29, 2018

"Trumpism, progressivism triumph in Tuesday's primaries as key November races take shape."

That's the ABC headline.
Gillum’s victory isn’t just a political victory for Bernie Sanders but is a major notch on the belt for progressive policies and the movement nationwide. The 39-year-old Tallahassee mayor’s victory as the Democratic gubernatorial nominee in the nation’s third-largest state is arguably as important as Alexandria Ocasio-Cortez’s upset over Rep. Joe Crowley in June....

DeSantis’ triumph in Florida is yet another indication that Republicans in the state are ready to embrace Donald Trump’s style of politics. The candidate had his children literally building a wall in a recent campaign ad, and earned the president’s backing very early in the race, a factor that clearly made a difference in his victory over Adam Putnam.

120 comments:

tim in vermont said...

Drive through Florida and you will see plenty of signs that Florida embraces Trump already. I will be shocked if the ‘R’ loses and will also be shocked if it’s not chalked up to plain old racism.

David Begley said...

The lines are clearly drawn.

Trump wins 40 states. The GOP holds the House.

Brennan, Comey, McCabe, Strzok, Ohr, Paige, Rice, Clapper and Power all indicted for numerous federal crimes.

Tommy Duncan said...

The core of the Democrat base has become solidly socialist. Fortunately, they don't yet compose 50% of the voting population.

How can so many be ignorant of (or unbothered by) the history of Lenin, Stalin, Castro, Pol Pot and Mao?

Achilles said...

excellent.

tim maguire said...

Joe Crowley is still in that New York race. There are essentially 2 Democrats running and if he wants to stay in the House (which I think he does since he refused to take his name off the ballot), it would be foolish to rule him out as a contender.

Ralph L said...

If the Republicans don't build the Wall, they're going the way of the Whigs, as the Trump prosperity will only attract more illegals.

Achilles said...

Why isn’t the media calling out Trump for predicting a red wave?

Do the democrats have anything at all to run on?

Open borders. Raising taxes. Crony trade.

Unpopular.

Speaker Jim Jordan.

Going to be a rude awakening for leftists when the republicans in the house are not led by the cuck wing of the Democrat Party. Going to be a rude awakening for the cuck wing of the Democrat Party when they have half their membership retire and the republicans gain seats.

Achilles said...

Ralph L said...
If the Republicans don't build the Wall, they're going the way of the Whigs, as the Trump prosperity will only attract more illegals.

The CoC traitors announced retirement in masse.

They thought it would put the democrats in power and they would get cushy lobbying gigs in the next iteration of the uniparty government.

They were just listening to the Acela echo chamber and thought they were more popular than they actually are.

They will not hold us back much longer. Mueller and Comey destroyed and are destroying the reputations of all life long republicans.

mccullough said...

Guess Arizonans like McSenators who are former pilots

AllenS said...
This comment has been removed by the author.
AllenS said...

I hope that the newest AZ McSenator doesn't become like the earlier McSenator, and become McI'llDoTheOppositeOfWhatIPromisedWhenIRan.

Freder Frederson said...

How can so many be ignorant of (or unbothered by) the history of Lenin, Stalin, Castro, Pol Pot and Mao?

Oh yeah, universal health care and minimum wages that still wouldn't match that of Australia's is one step away from the Gulag.

Qwinn said...

Freder, how hard is it to comprehend that if the government controls health care, it has the power of life and death over its citizens? Will you consider it a success if, instead of shipping conservatives to a gulag, they're just eliminated by denying care instead? My guess is probably.

DRP said...

Gillum is dirty. He's got an FBI investigation hanging over him. A real one, not a made up collusion one. Don't be surprised if he is indicted for the shenanigans he was up to as mayor of Tallahassee.

gilbar said...

How can so many be ignorant of (or unbothered by) the history of Lenin, Stalin, Castro, Pol Pot and Mao?

huh? I think Lenin was in some sixties band, wasn't he? What sort of music did those other dudes play? Socialism is ALL ABOUT che guevara, and how COOL his hat was

Freder Frederson said...

Freder, how hard is it to comprehend that if the government controls health care, it has the power of life and death over its citizens?

The most "radical" (and I put that in quotes, because it is far from radical compared to other nations) plan being discussed for this country is "Medicare for all". If you wanted to opt out of Medicare and get private insurance, no one would stop you.

Hagar said...

"Obamacare" controls the medical insurance business; not the medical profession and "health care." It looks to become a clusterfuck of the Gov't, the insurance companies, and major hospitals and clinics. If you need health care, you may have trouble finding a doctor to help you with that.

Andrew said...

If Trump tweets about Gillum but calls him "Gollum," the race is over.

Henry said...

I think something could be made of removing the comma -- which is how I read it at first glance on my phone: Trumpism progressivism. Let Trump spread out the benefits. Progressivism gets their strong man.

Trumpism progressivism. Trumpressivism? It's a little close to Trumpessimism.

Meade said...

Protrumpivism.

Original Mike said...

”If you wanted to opt out of Medicare and get private insurance, no one would stop you.”

Not true. HillaryCare would have made this illegal. In about 2012, there was a referendum placed on the Arizona ballot to add to their constitution the right to buy your own health care. The left fought it tooth and nail.

If the left has their way the government, and only the government, will provide health care.

Henry said...

how hard is it to comprehend that if the government controls health care, it has the power of life and death over its citizens?

People retain the power of life simply by waking up and not causing themselves harm. Almost all actuarial statistics have a foundation of healthy people who aren't malnourished or fighting a war. Mao didn't kill millions by raising their deductibles.

If you make your rhetorical question more specific, you would have to say that if the government controls health care, it has the power of life and death over the very old, the very sick, and the very poor.

That power the government has had for decades -- because insurance companies don't cover the very old, the very sick and the very poor.

exhelodrvr1 said...

Progrumpism

DanTheMan said...

I'm feeling sad this morning. Apparently the Russians don't care enough about us Floridians to hack our elections.

I thought we were special....

tcrosse said...

Trumpelstiltskinism, Call it by its name.

Roy Jacobsen said...

How can so many be ignorant of (or unbothered by) the history of Lenin, Stalin, Castro, Pol Pot and Mao?

Don't leave out Che.

I've been having a relatively civil discussion with a "Democratic Socialist," who expressed skepticism when I stated that many liberals think the people listed above are dandy exemplars of socialism. I asked him to do a search on amazon.com (be sure to use the Althouse link!) for "Che Guevara t-shirt."

At any rate, I'd say it's a combination of both ignorant (given what passes for education in modern academia) and unbothered (omelets and eggs, you know).

rehajm said...

How can so many be ignorant of (or unbothered by) the history of Lenin, Stalin, Castro, Pol Pot and Mao?

Oh yeah, universal health care and minimum wages...


Asked and answered in one fell swoop: 'Free stuff' from a maternal government is such a compelling argument for the ignorant. It's difficult to overcome because math is hard.

Henry said...

'Free stuff' from a maternal government is such a compelling argument for the ignorant.

And Mexico will pay for it.

Getting back to Florida man.

CJinPA said...

"Democrat Primary Results Show Voters Support Progressive Policies"
"Republican Primary Results Show Voters Succumb to Shrill Politics"

That's been the media's schtick for quite some time. Democratic victories indicate an evolving electorate choosing sound policy. Republican victories indicate voters were duped into acting on their darker impulses.

As it always was, and as it will always be.



Wince said...
This comment has been removed by the author.
cacimbo said...

NPR had one muted four minute segment on the primary results.If the numbers had been reversed with more Democrats turning out than Republicans there would have been multiple segments glorifying the coming blue wave.The 24/7 hate on Trump does not appear to be helping Dems in swing states like FL.

Wince said...

Assuming the key to Gillum's victory was the enthusiasm turned out his primary vote, the interesting question is what will the over half of Florida Democrats who didn't vote for Gillum do in the general election?

Sebastian said...

Most interesting tidbit today: Richard Trumka sounding positive and pro-Trump on NPR about the new deal with Mexico. Didn't take the bait from the NPR interviewer about not trusting Trump.

Of course, if the AFL-CIO likes it, we conservatives must shudder a bit. But then the politics may just work out well for Trump. Cuz "working people" will benefit, said Trumka.

I Callahan said...

Oh yeah, universal health care and minimum wages that still wouldn't match that of Australia's is one step away from the Gulag

“Wherever there is a jackboot stomping on a human face there will be a well-heeled Western liberal to explain that the face does, after all, enjoy free health care and 100 percent literacy.”

John Derbyshire was correct again.

Drago said...

2009 lefty: "If you like your doctor, you can keep your doctor. Period."

2018 lefty Freder: "If you wanted to opt out of Medicare and get private insurance, no one would stop you"

LOL

BTW, Hillary's original plan would have forced everyone into the govt plans.

Too, too easy.

Tell us more about that Bundy case there Freder. You seemed really up to speed on all the "facts" about that!...

Henry said...

“Wherever there is a jackboot stomping on a human face there will be a well-heeled Western liberal to explain that the face does, after all, enjoy free health care and 100 percent literacy.”

I'm not sure what you guys would do for arguments if you didn't have your strawmen.

Proposed: A minimum wage.
Response: STALIN!

It's like having a discussion with Enid Strict.

DanTheMan said...

>And Mexico will pay for it.

I think we should tax all foreigners living abroad.

Henry said...

I think we should tax all foreigners living abroad.

LOL.

Big Mike said...

Freder does not accept that socialism is impossible without the gulag. Whether he accepts it or not, it happens to be true.

Henry said...

We should tax all foreigners who live in foreign countries.

Henry said...

Freder does not accept that socialism is impossible without the gulag. Whether he accepts it or not, it happens to be true.

By socialism, you assert Stalinism, which is not being proposed. The proposal from the left is for healthcare delivery to follow a Western European, Australian, or Canadian model.

Those Canadian gulags would be almost as cold as the Siberian ones if they existed.

There are arguments against socialism, but continuously conflating it with Stalinism is a dull tactic.

Ingachuck'stoothlessARM said...

"some people call me Maurice,
because I speak of the Pro-Trumpitus of Love"

just to be clear.

LYNNDH said...

Yep, that good old min wage in Aust. Of course a cup of coffee (and not Starrot) will cost you $10.

If FL elects the Dem, it will go broke and all the older folks will have to move out because of the high taxes it will take. As FL goes so goes CA, NY and IL.

CJinPA said...

"Wherever there is a jackboot stomping on a human face there will be a well-heeled Western liberal to explain that the face does, after all, enjoy free health care and 100 percent literacy.”

That's a keeper.

Michael K said...

Blogger mccullough said...
Guess Arizonans like McSenators who are former pilots


Lots of military retirees, especially in Tucson.

There are arguments against socialism, but continuously conflating it with Stalinism is a dull tactic.

Spoken like someone who doesn't read British or Australian newspapers.

Why do you think those big medical centers are located in Minnesota and Spokane ?

Spend a few days in a B&B in Spokane and meet all the Canucks there for medical care,

JackWayne said...

Then Henry, you will have a stirring defense of Britain’s NHS. Let’s hear all about how good it is.

mockturtle said...

There is nothing progressive about socialism.

mockturtle said...

Slightly disappointed that Kelli Ward lost to McSally. I had predicted it would be much closer but never thought Arpaio would GARNER as many votes as he did.

Krumhorn said...

The minimum wage is counterproductive. On balance, it hurts the very folks who need entry level jobs the most by depriving them of those very jobs. But the progs don’t just shriek for minimum wage. It’s a Living Wage that must be paid for work that doesn’t merit that economic value. A Living Wage is the objective of the lefties until they can get to the point where we all get a Fair Share of a wealthier guy’s assets.

And those of us who profoundly disagree get to go to reedukation kamp.

The Florida leftie will be soundly thumped in November. No question about it. The Feders and the Henrys live in their MSNBC/Nation echo chamber and fail to grasp that the rest of us despise them for their truly racist and Fascist tendencies.

- Krumhorn

Henry said...

@Jack Wayne -- Just looking at first world Western democracies, health insurance schemes suck everywhere. That's the baseline. I'm anti-ideological. Drop the ideology and there's actually a discussion to be had.

mockturtle said...

No one I know in the UK uses the NH system but all have private insurance. If you like long queues and marginal medical treatment, then the NHS is for you. Quite a few Canadians I know come to the US for medical procedures they would have to wait a year for in Canada. One woman I knew from BC told me she had to wait three months for a breast biopsy after a mammogram showed a tumor.

wwww said...



Tea party people made a terrible mistake. Millennials don't know what socialism is. They did not grow up understanding or living the Cold War.

Tea Party people Spent the last 10 years calling the minimum wage, social security, medicare & maternity leave= SOCIALISM

Now a generation of Americans think FDR's New Deal = SOCIALISM.

But a lot of people like social security, the minimum wage, medicare, and they'd like their wife to be able to take a couple of weeks off without losing their job after having a baby.

You confused your millennial generation. Many of them think Canada, Australia, New Zealand, Germany, & Sweden are SOCIALIST countries because that's what you've been telling them for a generation.

sinz52 said...

"John Derbyshire was correct again."

Was John Derbyshire also correct when he wrote this in 2012:

"I actually think 'White Supremacist' is not bad semantically. White supremacy, in the sense of a society in which key decisions are made by white Europeans, is one of the better arrangements History has come up with."

I Callahan said...

Proposed: A minimum wage.
Response: STALIN!


You may want to read the thread again. I was responding to Freder's defense of socialism:

"How can so many be ignorant of (or unbothered by) the history of Lenin, Stalin, Castro, Pol Pot and Mao?"

"Oh yeah, universal health care and minimum wages that still wouldn't match that of Australia's is one step away from the Gulag."

sinz52 said...

"You confused your millennial generation. Many of them think Canada, Australia, New Zealand, Germany, & Sweden are SOCIALIST countries because that's what you've been telling them for a generation."

That's not the only problem.

Throughout their history, Americans have been famously pragmatic and non-ideological. That's why they can vote for a liberal candidate in one election and a conservative candidate in the next. (Some of Trump's Midwest supporters had voted for Obama previously.)

Young Americans are willing to try "Medicare for All" because the only other alternative is the Obamacare tweak to the existing healthcare mess.

The failure of the GOP's "repeal and replace" of Obamacare has left the GOP and conservatives generally with NO alternatives to offer. Ironically, that puts the GOP in the position of defending the status quo--which now *includes* Obamacare, which they had failed to get rid of.

I Callahan said...

Just looking at first world Western democracies, health insurance schemes suck everywhere. That's the baseline. I'm anti-ideological. Drop the ideology and there's actually a discussion to be had.

Ok, then let's have this discussion. Disclaimer: I work for a health insurance company and have been in that line of business for 29 years. Explain how they suck, and why, and what things you'd change to make the "schemes" suck less.

I Callahan said...

Also, I'll venture to say that your first assertions about how insurance works, and the causes of the issues, are wrong from the word go.

I Callahan said...

By socialism, you assert Stalinism, which is not being proposed. The proposal from the left is for healthcare delivery to follow a Western European, Australian, or Canadian model.

The old "it just wasn't implemented the right way" argument. For starters, Western Europe, Australia and Canada aren't socialist - they're mixed economies.

Those Canadian gulags would be almost as cold as the Siberian ones if they existed.

Straw man - see prior comment.

There are arguments against socialism, but continuously conflating it with Stalinism is a dull tactic.

Other than degree, they're one in the same. One is just more severe than the other.

The Crack Emcee said...

DeSantis warns Floridians not to "monkey this up" by electing Gillum

I don't know if what happens on this blog adds context to the larger world, or, if it's the other way around.

I Callahan said...

Was John Derbyshire also correct when he wrote this in 2012:

Ah, the old "they said one bad thing; therefore, everything else they say is bad".

You're going to have to try harder than that, because it's not an argument.

I Callahan said...

DeSantis warns Floridians not to "monkey this up" by electing Gillum

Aaaaandd the race card comes out. Of course.

mockturtle said...

OK. I don't get the monkey/race connection. I've known people of all three major 'races' who looked like some form of ape. Where did the idea come from that it has to do with blacks? Chimpanzees have blue eyes and straight hair, do they not?

CJinPA said...

"Monkey" as a verb:

verb (used without object), mon·keyed, mon·key·ing.
Informal. to play or trifle idly; fool (often followed by around or with).

"The last thing we want to do is monkey this up..." (fool around with) referring to a perceived thriving Florida economy.

Original Mike said...

”Explain how [the current health insurance structure] suck[s], and why, and what things you'd change to make the "schemes" suck less.”

They suck because they are not insurance, but prepaid health care. They suck because the insured have no skin in the game. They suck because there is no functional competition which would improve care and lower costs.

Current “universal health care” schemes would make all of this worse.

Freder Frederson said...

You may want to read the thread again. I was responding to Freder's defense of socialism

He read the thread. Derbyshire's quote was a ridiculous response to my post. Universal Healthcare and a return to a minimum wage with the earning power of the minimum wage we had in this country in the sixties is hardly socialism.

JackWayne said...

Henry says “I am anti-ideological”. So let’s look at the definition: “a system of ideas and ideals, especially one that forms the basis of economic or political theory and policy.” I think Henry is claiming to be an anarchist as He is ANTI-any system of ideas and ideals. But why do I have the feeling that if we scratch the surface of Henry we will find a very ideological person. One who is actually anti-capitalism.

Henry said...
This comment has been removed by the author.
Henry said...

I Callahan said...
The old "it just wasn't implemented the right way" argument. For starters, Western Europe, Australia and Canada aren't socialist - they're mixed economies.

Yes. You establish my point. Which is why the conflation of universal health care with socialism with Stalinism is a tedious attack. Many Western democracies provide some manner of universal health care. Many have some manner of small-s "socialist" institutions. Sometimes they even have some history of large-S Socialist governments. None of them are socialist, let alone Stalinist.

I said...
Those Canadian gulags would be almost as cold as the Siberian ones if they existed.

I Callahan said...
Straw man - see prior comment.

No. It's sarcasm. I'm making fun of the conflation I describe above.

I said...
There are arguments against socialism, but continuously conflating it with Stalinism is a dull tactic.

I Callahan said...
Other than degree, they're one in the same. One is just more severe than the other.
Other than degree, those Canadian gulags would be as cold as the Siberian ones if they existed.

That's sarcasm again. You start out by carving out a distinction that supports my position more than yours -- the fact that universal health insurance is being provided by countries with mixed economies. You end by asserting that small-s socialism is one-in-the-same as Stalinism.

* * *

Explain how they suck, and why, and what things you'd change to make the "schemes" suck less.

As to the first question: There are two primary ways to control healthcare costs. One way is limiting treatment options. The other is reducing what health providers make. These are universal issue. You can't control health costs without doing both of them. It happens in the U.S. market and it happens in the national systems elsewhere. It pretty much sucks if you need treatment not part of the broad swath of approved treatments and it pretty much sucks if you need access to specialists who won't join a health insurance network because the health insurance company won't let them do their work properly.

How do you make the schemes suck less? They all suck.

Henry said...

Original Mike said...

They suck because they are not insurance, but prepaid health care. They suck because the insured have no skin in the game. They suck because there is no functional competition which would improve care and lower costs.

All good points.

A fee-for-service regime that allowed people to purchase directly from providers might address some of those points. But it's not going to happen in the U.S. because of entrenched interests.

Freder Frederson said...

They suck because there is no functional competition which would improve care and lower costs.

We have more competition in medical care in this country than in the systems you deride, yet we still spend more (at least 50% more than the next country spends) and cover fewer people.

And the idea of competition in health care is bizarre at best. It may work for non-critical and elective procedures. But are you really going to start calling around to find the best deal when you are suffering a stroke or heart attack? The consumer knowledge that would be required in a "competitive" health care system would overwhelm the vast majority of people. Hell, even some of our most brilliant people make really stupid health care decisions (e.g., Steve Jobs).

Original Mike said...

”There are two primary ways to control healthcare costs. One way is limiting treatment options. The other is reducing what health providers make. These are universal issue. You can't control health costs without doing both of them.”

You’re problem is that you only entertain measures involving government controls.

Original Mike said...

”But are you really going to start calling around to find the best deal when you are suffering a stroke or heart attack?”

No, your health insurance company would have done that. But under the current system the health insurance companies are shielded from competition.

Original Mike said...

As are the health care providers.

Hagar said...

"Who controls the gold gets to rule."
If you are not the payer and do not even have a choice of what doctor to see, they are not going to waste their time listening to your tale of woe.
You will be tested and treated as specified by "the system." Resistance is futile.

Original Mike said...

Article in the WSJ last week. Health care provider in La Crosse charges $50k for a knee replacement. Where that number comes from nobody knows, so they do the work of determining what a knee replacement actually costs them to provide. Answer? $10k.

Henry said...

Original Mike said...
You’re problem is that you only entertain measures involving government controls.

I'm describing the way private health insurance controls costs. Private health insurance attempts to control costs by limiting treatments and by narrowing provider networks. Narrowing networks to those practices, clinics, and hospitals that agree to the insurance companies treatment and compensation allows the insurance company to cost-control it's policies.

However, the narrower the network the harder it is to access specialists. Need a specialist practitioner and the insurance company typically covers less. Need a specific treatment and the insurance company may elect not to cover it at all.

National health insurance does exactly the same thing, of course.

But the idea that competition will decrease costs and improve treatment ignores the fact that most people don't need specialists. So the first order of cost reduction -- to make policies more attractive to customers -- is to do exactly as I describe.

mockturtle said...

Crack, probably being facetious, is like Woody Allen talking to his friend in Annie Hall: Jew eat?

Hagar said...

@Original Mike,
My barber had both knees replaced at the VA and I think he said the bill was for $150,000.

Hagar said...

I went to the Presbyterian about a skin problem that worried me, but the dermatologist said it was not a problem and refused to do anything about it. However, she thought a couple of spots on my back might be melanoma and insisted on removing those. Her bill for that was $600, and I made a remark to the clerk that that was pretty good pay for ten minutes work. She looked at me coldly, and said, "Well, she gave you a 50% discount."

Howard said...

Notice how ignorant deplorable bigots quickly become erudite English Professors and technicality Lawyers to create a Harvey Weinstein defense of a racist slur.

sinz52 said...

"No, your health insurance company would have done that. "

And consumers will insist on the widest possible networks.

That's why a lot of consumers will still choose Blue Cross, because in many locations like mine, it still offers the widest choice of doctors and hospitals. When consumers have more than one choice of health care plan to choose from, they don't just look at the amount of the premium. They also consider whether there are doctors located near them and whether there are hospitals in the network with good reputations.

If your "solution" is to have private insurers required to narrow their networks by government fiat, that's no improvement over Obamacare.

In any case, this whole discussion is moot. All these half-baked ideas being suggested by individual conservatives on forums like this one haven't got a prayer of ever being incorporated into an actual congressional GOP bill.

The GOP Congress has dropped the healthcare issue altogether, since they don't want to remind voters of what happened the last time they took up the issue.

Senate and House Dems are sponsoring actual proposals.
Senate and House Republicans are sponsoring nothing.

I Callahan said...

They suck because they are not insurance, but prepaid health care. They suck because the insured have no skin in the game. They suck because there is no functional competition which would improve care and lower costs.

So it's not the "insurance" itself that sucks; it's the fact that people don't have skin in the game. That's not "insurance's" fault. And in most large markets, there are competitors.

Original Mike said...

”If your "solution" is to have private insurers required to narrow their networks by government fiat, that's no improvement over Obamacare.”

I have no clue where you got the idea that I would support that.

Tyrone Slothrop said...

"The power of life and death" might be a bit of an overstatement vis-a-vis government-run healthcare, but the reality is actually worse. Everything-- everything-- affects your health. If your behavior can be construed as negatively affecting the government's bottom line, the government will have all it needs to ban your behavior. A small sample: Motorcycles, hang gliding, booze, salt, guns, tobacco (vaping!) would be characterized as costing the taxpayer money. There wouldn't even be discussions about it. Gone. That's the reality. That's how governments work.

I Callahan said...

Yes. You establish my point. Which is why the conflation of universal health care with socialism with Stalinism is a tedious attack. Many Western democracies provide some manner of universal health care. Many have some manner of small-s "socialist" institutions. Sometimes they even have some history of large-S Socialist governments. None of them are socialist, let alone Stalinist.

Including ours - Medicare, Medicaid, etc. A VERY large portion of people of our country are covered by universal health care programs like the above.

Other than degree, those Canadian gulags would be as cold as the Siberian ones if they existed.

And then:

That's sarcasm again. You start out by carving out a distinction that supports my position more than yours -- the fact that universal health insurance is being provided by countries with mixed economies. You end by asserting that small-s socialism is one-in-the-same as Stalinism.


No, you're the one contradicting yourself. Is Canada socialist or not? If not, then they won't have gulags. If so, then you have to delineate the difference between actual socialism and actual Stalinism. Hint: Stalin referred to his system as socialist. The Union of Soviet SOCIALIST Republics.


As to the first question: There are two primary ways to control healthcare costs. One way is limiting treatment options. The other is reducing what health providers make. These are universal issue. You can't control health costs without doing both of them. It happens in the U.S. market and it happens in the national systems elsewhere. It pretty much sucks if you need treatment not part of the broad swath of approved treatments and it pretty much sucks if you need access to specialists who won't join a health insurance network because the health insurance company won't let them do their work properly.

Mostly true, but all that aside - you're extremely naive if you think a universal system won't do the EXACT same thing regarding specialists and the like. They will, and do in countries that have your vaunted universal system. That aspect won't change, and at least in a system with insurance, you can get the government on your side when you have a beef about that. Good luck with that when the insurance company IS the government.

How do you make the schemes suck less? They all suck.

If that's the case, all healthcare schemes "suck". You've already admitted that. Even in the systems you give more cred.

I Callahan said...

But it's not going to happen in the U.S. because of entrenched interests.

But it's not going to happen in the U.S. because people don't want to pay out of their pocket for healthcare.

Fixed that for you.

I Callahan said...

But under the current system the health insurance companies are shielded from competition.

This is another one of those things people think about insurance companies that has no basis in reality. In the market I live in (Detroit), there are at least 8 different large insurers. And yes, they do compete with each other; however, they compete for employers, NOT actual healthcare consumers. THAT'S what's wrong with the system, as you already pointed out: consumers don't have a dog in the fight.

And as for how they contract with actual providers - it's CMS (Medicare) who sets the price structure for EVERYONE. As usual, the government gets involved, and it all goes to shit. I can't tell you how many times I hear complaints from doctors that they're getting screwed on fee schedules for things they do regularly.

I Callahan said...

Article in the WSJ last week. Health care provider in La Crosse charges $50k for a knee replacement. Where that number comes from nobody knows, so they do the work of determining what a knee replacement actually costs them to provide. Answer? $10k.

This is media-driven bullshit. I see the prices for things on a daily basis. A provider may CHARGE $50K, but that's NOT what they're paid. They're paid a fraction of that. And NO ONE, including those who don't have insurance but are rich, is going to pay $50K for that. They'll negotiate the rate way down, to a level closer to what insurance companies pay.

That $50K is what hospitals WISH to get for the procedure. Leave it up to the media to make people think that's what they're getting. The difference between charges and allowed is what's called "contractual allowance", and it's on every hospital's financial statements. Allowed is about 30-40% of charges.

Ice Nine said...

>>"the dermatologist...thought a couple of spots on my back might be melanoma and insisted on removing those. Her bill for that was $600, and I made a remark to the clerk that that was pretty good pay for ten minutes work."<<

You didn't pay her for ten minutes work -- you paid her for knowing which spots needed to be removed.

I Callahan said...

Senate and House Dems are sponsoring actual proposals.

Those proposals are for the government, who caused the problem in the first place, to effectively take the system over completely. If you're going to argue that's a good thing, make that argument. But I'd take the GOP's non-proposals over the Dem's proposals first, any day of the week. Not screwing something up worse is better than screwing it up.

Henry said...

”If your "solution" is to have private insurers required to narrow their networks by government fiat, that's no improvement over Obamacare.”

No need to have Obamacare requiring narrow networks when the insurance market pushes the same thing. The narrow network model is more cost-effective for the insurer and also heavily weighted toward the inclusion of institutions -- large practices and hospitals -- in place of individual practitioners who can't afford the paperwork.

If one were to conceive a way to provide low-cost health services from the ground up it could be a completely different model. Small urgent care and retail clinics served by nurses and medical assistants and run on a fee-for-service model with government credits for the poor could provide low-cost coverage for basic checkups, maintenance of chronic conditions, and simple emergency care.

But beyond that the problem still exists for when patients can access more expensive services, who makes those decisions, who pays, how are the costs communicated between provider, insurer, and patient.

Phil 314 said...

National Media noted McSally’s affinity for Trump as a reason for her victory.

EVERY candidate in the Republican primary was pro-Trump. Donald Trump specifically gave a shout out for Kelli Ward earlier this year. And of course Sheriff Joe was a big Trump supporter in 2016.

McSally was late to the Trump train and frankly it doesn’t fit her style, as best as I can tell (she represents Tucson, not Phx.)

This fall will be interesting as Sinema has really focused on the Phx VA scandal in the last couple of years, ingratiating her with the vets. McSally IS a vet.

This year old opinion piece by Rob Robb, conservative columnist, brings up some interesting aspect of Sinema’s move to the center..

It’s been years since I’ve heard her talk about her bisexuality.

Phil 314 said...

Once again a bad link embed.

Here it is:

https://www.azcentral.com/story/opinion/op-ed/robertrobb/2017/10/04/leave-prada-socialist-alone/728717001/

Original Mike said...

”That $50K is what hospitals WISH to get for the procedure. Leave it up to the media to make people think that's what they're getting.”

Yeah, but nobody knows how much. That’s anti-competitive. Making prices transparent would do wonders for this market.

Henry said...

But it's not going to happen in the U.S. because people don't want to pay out of their pocket for healthcare.

Since most people have health insurance from their employer, they are paying for their coverage, just in an obfuscated way. This, by the way, is one entrenched interest. All the bizarre charges that are actually much less, routed between insurer, provider, and consumer in a fashion intended to confuse is certainly an argument for fee-for-service. You just need to figure out a way to get there from here.

Krumhorn said...

Universal Healthcare and a return to a minimum wage with the earning power of the minimum wage we had in this country in the sixties is hardly socialism.

If that's the case, why is it that so many of the most ardent proponents of those wealth redistributive policies, such as Ocasio-Cortez and Gullem and Bernie, call themselves.....er...socialists?

It's a fundamental truth that if you scratch a leftie, you'll find a tyrant screaming to get out....which is where the gulags come in.

- Krumhorn

Henry said...

If that's the case, all healthcare schemes "suck". You've already admitted that. Even in the systems you give more cred.

Since I haven't given any systems more cred, I'll leave this discussion as 'all healthcare schemes "suck". I've already asserted that.'

Hagar said...

You didn't pay her for ten minutes work -- you paid her for knowing which spots needed to be removed.

Yes, I know that old joke (except it is about an expert machinist), but altogether with preliminary examination, a session with her liquid nitrogen spray can, check-up, and removal of stitches, my total cost came to nearly $1,000, and she still had done nothing about the problem spot that I had asked her to fix.

(I finally got that taken care of when my neighbor's sister, who is a pediatrician, came by for a visit and looked at it and said she was going over to Walgreen's for something anyway and would get me something to put on it, and that worked.)

Gospace said...

Henry said...
Freder does not accept that socialism is impossible without the gulag. Whether he accepts it or not, it happens to be true.

By socialism, you assert Stalinism, which is not being proposed. The proposal from the left is for healthcare delivery to follow a Western European, Australian, or Canadian model.


Not familiar with the Australian model, but Western European and Canadian style healthcare is great as long as you're under 65, healthy, and don't have an expensive to treat disease. And don't mind being put on a waiting list for treatment.

Current Alberta waiting times: https://albertaboneandjoint.com/patients/wait-times/
57 weeks for the surgeon consult. 51 weeks for the surgery.

From the time my wife and orthopedist decided it was time to replace her knee to the replacement being done was under 6 weeks. Time to order and receive the right knees, set up the surgery, and prepare the house for her recovery. Putting in grab bars, extra handrails, etc. A week before the surgery a visiting nurse came in to tell me what to set up. She looked at what I had already installed and decided the prep was done.


Up to 6 years waiting time in Great Britain. http://www.dailymail.co.uk/health/article-82465/The-year-wait-new-knee.html

The waiting list for voluntary euthanasia in Europe is much shorter. And they'll even do involuntary euthanasia in the Netherlands for you. Not available in most U.S. jurisdictions.

Gospace said...

Henry said...
As to the first question: There are two primary ways to control healthcare costs. One way is limiting treatment options. The other is reducing what health providers make. These are universal issue. You can't control health costs without doing both of them.


Or, and this is the truly radical idea- introduce competition. Insurance doesn't cover laser eye surgery. That's as high tech as it comes when it comes to surgery. The consumer price has been steadily dropping and the results getting steadily better. So far 2 of my kids have had it, paid out of pocket.

Dental implants aren't covered by insurance. Don't know the cost curve on them, but the ads to get dental implants show up daily on my facebook feed. So they must be somewhat affordable.

There is some competition for healthcare. Our orthopedist has his own MRI machine, run as a separate business. Waiting time to get in if you need an MRI- same day.

A lot of medical tests could be unbundled from doctor visits. Walk into the local pharmacy and order up a CBC, A1C, or cholesterol test. I can already get my yearly flu shot in the pharmacy, and do. It's easier and more convenient.

DanTheMan said...

>>That $50K is what hospitals WISH to get for the procedure. Leave it up to the media to make people think that's what they're getting.”

That's very true. When our last child was born, a totally routine delivery, the "bill" was $13,000.
Our insurance company negotiated rate was about $1,500. (a 90% discount!!)
Our copay was about $300.
So, depending on what point you are trying to make, that delivery cost $13,000, $1,500, or $300.

mockturtle said...

Phil 3:14 asserts: National Media noted McSally’s affinity for Trump as a reason for her victory.

And they would be wrong. McSally was, until recently, a Never-Trumper. Realizing that Trump was, in fact, popular with GOP voters, she spun like a top. This is why I supported Ward.

mockturtle said...

My younger daughter texted me a meme that showed half a 'Bernie for President' bumper sticker with a note tacked on that said: I took half of your sign because you had one and I didn't. I'm sure you understand.

Freder Frederson said...

If your behavior can be construed as negatively affecting the government's bottom line, the government will have all it needs to ban your behavior. A small sample: Motorcycles, hang gliding, booze, salt, guns, tobacco (vaping!) would be characterized as costing the taxpayer money. There wouldn't even be discussions about it. Gone. That's the reality. That's how governments work.

Just like has happened in every country that has universal healthcare! You can't even get a beer in Germany or a glass of wine in France anymore. BMW had to stop making motorcycles because they are banned in the EU. And Fish and Chip Shops (and if you think Fish and Chips are good for you, you have never been to a good old fashioned English "Chippie") have been banned in England.

Hagar said...

Norway never was "socialist." The Labor Party was avowedly socialist, but has now forsworn that label and, along with most other European labor parties - even the mother of them all, the British Labour Party - declared itself a "social democrat" party.
However, the Norwegian Labor Party never was a majority party, they only ever had a plurality. Their high point was in 1948 with ~42.5% of the vote, iirc, and then a lot of their voters voted for them because of the name, the Labor Party, with no idea that the policies actually in the party's platform were 180 degrees off their own beliefs, which the Party well knew and kept in mind so as to not inadvertently disabuse them of their innocent ignorance.

Norway is a small and hardscrabble country (until they found oil in the North Sea in 1969) and has a long tradition of each community taking care of its own poor and infirm under the supervision of the local parish minister, who usually was pretty strict as to who did or did not deserve to be taken care of. They also a strong dislike for taking care of anyone else's poor and infirm, so a main part of the local sheriff's duties were to round up any strangers roaming about and chase them off.

Norway's system for general health care assistance when I grew up was a national health treasury funded by paycheck deductions that refunded 2/3 of the doctor's bill (signed by the doctor as "paid in full") and the bus ticket to come to town for the rural patients, if applicable.
This worked fine in Norway under pre-WWII conditions, but would not work even there today, and, of course, never in a large industrialized and diverse country like the U.S.

According to what I have read, Norway went more to an NHS-like system later, but are now again working to push health care - including hospitals and clinics - back to the local communities. It is still a small country where everybody knows everybody and everybody else's business, and you cannot do what they do here.

Bilwick said...

Remember, folks, that's "progressivism" in a statist context . . . the Cult of the State being about as retrogressive a theocracy as one can find.

Michael K said...

Didn't read the whole thread but

Just looking at first world Western democracies, health insurance schemes suck everywhere.

France is pretty good. Their problem is the high unemployment and the Brits all moving there and signing up for the part of the program intended for the poor.

The French system would be a good model for reform for us but it uses market mechanisms instead of rationing so the left would never accept it.

Freder Frederson said...

The French system would be a good model for reform for us but it uses market mechanisms instead of rationing so the left would never accept it.

You keep saying this but never actually provide any proof of your assertion.

Michael K said...

Blogger DanTheMan said...
>>That $50K is what hospitals WISH to get for the procedure. Leave it up to the media to make people think that's what they're getting.”

That's very true. When our last child was born, a totally routine delivery, the "bill" was $13,000.
Our insurance company negotiated rate was about $1,500. (a 90% discount!!)
Our copay was about $300.
So, depending on what point you are trying to make, that delivery cost $13,000, $1,500, or $300.


This is the problem with HSAs. The cash market is prevented from working by Medicare and the insurance comanies that have all negotiated huge discounts with providers.

The only way the cash market can work now is if the doctor drops all Medicare and insurance.

It has gotten so bad that some are doing so.

If you have a 20% "copay" your insurance may show you a bill for $10,000 and expect you to pay $2000. Then they pay the hospital/surgery center $1500, less than your 20%.

If you go there with cash, you pay the $10,000 "retail" price.

Michael K said...

You keep saying this but never actually provide any proof of your assertion.

Freder, I know you have trouble with logic but "proof" of a proposal requires it be done.

If you are really interested, I have an extensive study of the French system on line.

I wrote that up years ago and the left, like the commenters at Washington Monthly blog, hate the idea. I suspect you will, too.

MayBee said...

Remember when Obama/Gruber's argument was that employers would save so much on health insurance they would pass that on to the employees with higher paychecks?

langford peel said...

I wouldn't monkey around in this election.

The people will come out in droves to reject Gollum.

Michael K said...

Freder must be reading those studies of health care systems I posted.

Or else reading DailyKos for the talking points.

Michael K said...

Meanwhile, the FBI and judges cover up the New Mexico murder camp.

Is this a great country or what ?

Hagar said...

Calm yourself doctor. Those "terrorists" in the New Mexico "compound" were just some very ineffectual young people from the 'hood who should not have been camping out at that altitude with winter coming on.
It was just the dog days of August with Congress out of session and no other news.

Michael K said...

Calm yourself doctor.

Oh, yes. I'm calm and besides I have my CCW permit and my Browning 1911-380 in the car with extra magazines.

Freder Frederson said...

Freder must be reading those studies of health care systems I posted.

Well yes I did. And I am for it. As I posted earlier, I don't know how you became convinced that the left would object to such a system

Achilles said...

Michael K said...
Calm yourself doctor.

Oh, yes. I'm calm and besides I have my CCW permit and my Browning 1911-380 in the car with extra magazines.

If you are going to have a full size.45 why not have an fn .45 or hk .45 tactical?

More rounds, smoother action dot sight mount ...

Sorry I like to pester 1911 users.

Rusty said...

"Sorry I like to pester 1911 users."

It's OK. We 1911 users are used to caliber envy.

mockturtle said...

Michael K observes: If you go there with cash, you pay the $10,000 "retail" price.

Yes. The health care industry is the only business I know where you pay more if you pay cash.